White blood cell (WBC) classification plays a vital role in hematology for diagnosing various medical conditions. However, it faces significant challenges due to domain shifts caused by variations in sample sources (e.g., blood or bone marrow) and differing imaging conditions across hospitals. Traditional deep learning models often suffer from catastrophic forgetting in such dynamic environments, while foundation models, though generally robust, experience performance degradation when the distribution of inference data differs from that of the training data. To address these challenges, we propose a generative replay-based Continual Learning (CL) strategy designed to prevent forgetting in foundation models for WBC classification. Our method employs lightweight generators to mimic past data with a synthetic latent representation to enable privacy-preserving replay. To showcase the effectiveness, we carry out extensive experiments with a total of four datasets with different task ordering and four backbone models including ResNet50, RetCCL, CTransPath, and UNI. Experimental results demonstrate that conventional fine-tuning methods degrade performance on previously learned tasks and struggle with domain shifts. In contrast, our continual learning strategy effectively mitigates catastrophic forgetting, preserving model performance across varying domains. This work presents a practical solution for maintaining reliable WBC classification in real-world clinical settings, where data distributions frequently evolve.

How can we test AI performance? This question seems trivial, but it isn't. Standard benchmarks often have problems such as in-distribution and small-size test sets, oversimplified metrics, unfair comparisons, and short-term outcome pressure. As a consequence, good performance on standard benchmarks does not guarantee success in real-world scenarios. To address these problems, we present Touchstone, a large-scale collaborative segmentation benchmark of 9 types of abdominal organs. This benchmark is based on 5,195 training CT scans from 76 hospitals around the world and 5,903 testing CT scans from 11 additional hospitals. This diverse test set enhances the statistical significance of benchmark results and rigorously evaluates AI algorithms across various out-of-distribution scenarios. We invited 14 inventors of 19 AI algorithms to train their algorithms, while our team, as a third party, independently evaluated these algorithms on three test sets. In addition, we also evaluated pre-existing AI frameworks--which, differing from algorithms, are more flexible and can support different algorithms--including MONAI from NVIDIA, nnU-Net from DKFZ, and numerous other open-source frameworks. We are committed to expanding this benchmark to encourage more innovation of AI algorithms for the medical domain.

As a result of the rise of Transformer architectures in medical image analysis, specifically in the domain of medical image segmentation, a multitude of hybrid models have been created that merge the advantages of Convolutional Neural Networks (CNNs) and Transformers. These hybrid models have achieved notable success by significantly improving segmentation accuracy. Yet, this progress often comes at the cost of increased model complexity, both in terms of parameters and computational demand. Moreover, many of these models fail to consider the crucial interplay between spatial and channel features, which could further refine and improve segmentation outcomes. To address this, we introduce LHU-Net, a Light Hybrid U-Net architecture optimized for volumetric medical image segmentation. LHU-Net is meticulously designed to prioritize spatial feature analysis in its initial layers before shifting focus to channel-based features in its deeper layers, ensuring a comprehensive feature extraction process. Rigorous evaluation across five benchmark datasets - Synapse, LA, Pancreas, ACDC, and BRaTS 2018 - underscores LHU-Net's superior performance, showcasing its dual capacity for efficiency and accuracy. Notably, LHU-Net sets new performance benchmarks, such as attaining a Dice score of 92.66 on the ACDC dataset, while simultaneously reducing parameters by 85% and quartering the computational load compared to existing state-of-the-art models. Achieved without any reliance on pre-training, additional data, or model ensemble, LHU-Net's effectiveness is further evidenced by its state-of-the-art performance across all evaluated datasets, utilizing fewer than 11 million parameters. This achievement highlights that balancing computational efficiency with high accuracy in medical image segmentation is feasible. Our implementation of LHU-Net is freely accessible to the research community on GitHub.

Intrigued by the inherent ability of the human visual system to identify salient regions in complex scenes, attention mechanisms have been seamlessly integrated into various Computer Vision (CV) tasks. Building upon this paradigm, Vision Transformer (ViT) networks exploit attention mechanisms for improved efficiency. This review navigates the landscape of redesigned attention mechanisms within ViTs, aiming to enhance their performance. This paper provides a comprehensive exploration of techniques and insights for designing attention mechanisms, systematically reviewing recent literature in the field of CV. This survey begins with an introduction to the theoretical foundations and fundamental concepts underlying attention mechanisms. We then present a systematic taxonomy of various attention mechanisms within ViTs, employing redesigned approaches. A multi-perspective categorization is proposed based on their application, objectives, and the type of attention applied. The analysis includes an exploration of the novelty, strengths, weaknesses, and an in-depth evaluation of the different proposed strategies. This culminates in the development of taxonomies that highlight key properties and contributions. Finally, we gather the reviewed studies along with their available open-source implementations at our \href{https://github.com/mindflow-institue/Awesome-Attention-Mechanism-in-Medical-Imaging}{GitHub}\footnote{\url{https://github.com/xmindflow/Awesome-Attention-Mechanism-in-Medical-Imaging}}. We aim to regularly update it with the most recent relevant papers.